Subject: Re: Ear can be used to diagnose certain mental illnesses From: Denis Donovan <dmdonvan@xxxxxxxx> Date: Fri, 16 Oct 2009 15:06:30 -0400 List-Archive:<http://lists.mcgill.ca/scripts/wa.exe?LIST=AUDITORY>--============_-956402495==_ma============ Content-Type: text/plain; charset="iso-8859-1" ; format="flowed" Content-Transfer-Encoding: quoted-printable I would suggest that the "demonstration" Kevin=20 Austen refers to below be taken with a hefty dose=20 of lithium chloride and an even heftier dose of=20 curiosity and skepticism. =46irst, note the first and last paragraphs in the=20 associated story that was linked to the post.=20 This is what Bush wanted to do: have the power to=20 declare children mentally ill on a national=20 scale. Notice the primary "diagnosis" targeted:=20 "conduct disorder." George Orwell's Big Brother=20 is alive, thriving and expanding daily in the=20 English-speaking world. The issues dealt with by this list are typically=20 firmly grounded in the sensible world and are=20 subject to the rigors of good scientific method.=20 I happen to be interested in the developmental=20 neuroscience of musical cognition and there are=20 occasional shining nuggets to be found here. The=20 world of the stories below is as different from=20 what this list is typically about as apples are=20 from washing machines. My field, "psychiatry and the biobehavioral=20 sciences" does not have presently, and has never=20 had, a realistic phenomenology. However much my=20 field my delight in viewing itself as "modern=20 biological psychiatry" (Nancy Andreason's term in=20 "The Broken Brain"), the field has only rebranded=20 psychoanalytic and Piagetian concepts and models=20 and changed the terminology. And, do note that a=20 good decade after the so-called "Decade of the=20 Brain," my medical specialty is still without a=20 single valid and reliable diagnostic laboratory=20 test. Try to imagine internal medicine in the=20 same straits. To gain some perspective, just=20 consider that as our diagnostic acumen has=20 increased, everything -- from academic=20 achievement to everyday behavior -- has gotten=20 MUCH worse. Just one example -- which should be particularly=20 meaningful for Robert Zatorre since it took place=20 in his back yard. In 1991, the Canadian Province of Qu=E9bec asked=20 Jean-Jacques Breton, M.D., director of child=20 psychiatry research at the Rivi=E8re-des-Prairies=20 Hospital in Montr=E9al, to conduct a provincial=20 prevalence study of child psychiatric disorders.=20 Breton and his colleagues from the University of=20 Montr=E9al did something practically unheard of in=20 the field: they wondered if children would=20 actually understand the questions on the=20 assessment tool used to generate diagnoses-in=20 this case, the Diagnostic Interview Schedule for=20 Children (DISC-2), one of the most widely used=20 structured interviews developed by David Shaffer,=20 M.D. and his team at Columbia University. The=20 results were stunning. Nine-, 10- and 11-year-old=20 children understood only 38 percent of the=20 questions on the DISC-2. Given its intensely=20 embarrassing nature, I was astounded to see a=20 version of Breton's findings in the New Research=20 section of the 1993 annual meeting of American=20 Academy of Child and Adolescent Psychiatry. When=20 I asked him what his findings said about our=20 field, Breton replied with a very sad smile,=20 "That the child is of secondary importance in=20 child psychiatry." How true, I thought to myself,=20 but unfortunately your findings are likely have=20 zero impact on the education and mental health=20 community. Once again I was surprised to see the=20 establishment take note of Breton's troubling=20 data when, in July of 1995, the Journal of the=20 American Academy of Child and Adolescent=20 Psychiatry published a more polished version of=20 the 1993 New Research version. True to form, in=20 her discussion of the article, Mary Schwab-Stone,=20 M.D. of the Yale Child Study Center wrote that=20 "The endeavor to make the DISC good enough has=20 taken longer than anyone wanted, as work began on=20 it around 1980...." What Breton's data called=20 into question in 1991-and remains unchallenged=20 even today--is not the less-than-polished state=20 of the Diagnostic Interview Schedule for Children=20 but, rather, the field's very understanding of=20 children. It is sobering, to say the least, that=20 one of this country's premier academic child=20 psychiatry divisions could be so out-of-touch=20 with a realistic understanding of children that=20 it never even noticed that its instrument was=20 incomprehensible to the very children it was=20 designed to assess. That historical anecdote from our ever-increasing=20 "scientific" sophistication is but a minuscule=20 tip of an amazingly large and embarrassing=20 iceberg. http://www.theage.com.au/national/specialist-teams-will-target-youth-2009101= 4-gxfy.html=20 (101609) Specialist teams will target youth NICK MILLER October 15, 2009 =46our new youth mental health teams, due to be=20 announced this month, will go into schools, youth=20 centres and perhaps even shopping centres and=20 railways stations to identify and help young=20 people with early signs of mental illness. The teams will be on the look out for drug and=20 alcohol problems, depression, anxiety or eating=20 disorders, as well as the early stages of more=20 serious psychosis. They are the first steps in the State=20 Government's mental health strategy, released in=20 March this year, which has a new focus on=20 intervening early in mental illness. Minister for Mental Health Lisa Neville said the=20 teams would, for the first time, help young=20 people who would be classified ''not sick=20 enough'' in the existing system. Three-quarters of mental illness begins before=20 age 25, but due to a short supply of care only=20 the sickest of young people can get access. Paul Leyden, who runs child and adolescent mental=20 health at Eastern Health and will set up one of=20 the new teams, said it was a very exciting=20 initiative. ''We know 3 per cent of the=20 population have mental health issues but we are=20 seeing less than 1 per cent,'' he said. The teams will start work this year or early 2010=20 in eastern and western regions, followed by two=20 more at Southern Health and Peninsula Health=20 later next year. The Government is providing $13.8 million to=20 staff and resource the new teams, as well as $4.4=20 million for teams at primary schools to deal with=20 early ''conduct disorder'', and $2.9 million to=20 tackle autism. >[A] ... research group here in Australia has=20 >just demonstrated how a probe inserted in the=20 >ear can be used to diagnose certain mental=20 >illnesses when the patient is moved incertain=20 >ways in a '3D' chair! They make use of the=20 >proximity between certain auditory functions and=20 >other mental functions in the brain. > >Regards, >David > >Dr David Hirst >Curriculum, Teaching and Learning Centre >| La Trobe University | Bundoora 3086 Victoria Australia | > http://www.theage.com.au/national/diagnosis-to-rock-the-world-of-mental-heal= th-20091014-gxfx.html -- =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D Denis M. Donovan, M.D., M.Ed., F.A.P.S. Director, EOCT Institute Medical Director, 1983 - 2006 The Children's Center for Developmental Psychiatry St. Petersburg, Florida Mail: P.O Box 47576 St. Petersburg, FL 33743-7576 Phone: 727-641-8905 Email: DenisDonovan@xxxxxxxx =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D --============_-956402495==_ma============ Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable <!doctype html public "-//W3C//DTD W3 HTML//EN"> <html><head><style type=3D"text/css"><!-- blockquote, dl, ul, ol, li { padding-top: 0 ; padding-bottom: 0 } --></style><title>Re: Ear can be used to diagnose certain mental illnesses</title></head><body> <div><font face=3D"Arial">I would suggest that the "demonstration" Kevin Austen refers to below be taken with a hefty dose of lithium chloride and an even heftier dose of curiosity and skepticism.</font></div> <div><font face=3D"Arial"><br></font></div> <div><font face=3D"Arial">First, note the first and last paragraphs in the associated story that was linked to the post. This is what Bush wanted to do: have the power to declare children mentally ill on a national scale. Notice the primary "diagnosis" targeted: "conduct disorder." George Orwell's Big Brother is alive, thriving and expanding daily in the English-speaking world.</font></div> <div><font face=3D"Arial"><br></font></div> <div><font face=3D"Arial">The issues dealt with by this list are typically firmly grounded in the sensible world and are subject to the rigors of good scientific method. I happen to be interested in the developmental neuroscience of musical cognition and there are occasional shining nuggets to be found here. The world of the stories below is as different from what this list is typically about as apples are from washing machines.</font></div> <div><font face=3D"Arial"><br></font></div> <div><font face=3D"Arial">My field, "psychiatry and the biobehavioral sciences" does not have presently, and has never had, a realistic phenomenology. However much my field my delight in viewing itself as "modern biological psychiatry" (Nancy Andreason's term in "The Broken Brain"), the field has only rebranded psychoanalytic and Piagetian concepts and models and changed the terminology. And, do note that a good decade after the so-called "Decade of the Brain," my medical specialty is still without a single valid and reliable diagnostic laboratory test. Try to imagine internal medicine in the same straits. To gain some perspective, just consider that as our diagnostic acumen has increased, everything -- from academic achievement to everyday behavior -- has gotten MUCH worse.</font></div> <div><font face=3D"Arial"><br></font></div> <div><font face=3D"Arial">Just one example -- which should be particularly meaningful for Robert Zatorre since it took place in his back yard.</font></div> <div><font face=3D"Arial"><br></font></div> <div><font face=3D"Arial" color=3D"#000000">In 1991, the Canadian Province of Qu=E9bec asked Jean-Jacques Breton, M.D., director of child psychiatry research at the Rivi=E8re-des-Prairies Hospital in Montr=E9al, to conduct a provincial prevalence study of child psychiatric disorders. Breton and his colleagues from the University of Montr=E9al did something practically unheard of in the field: they wondered if children would actually understand the questions on the assessment tool used to generate diagnoses-in this case, the<i> Diagnostic Interview Schedule for Children</i> (DISC-2), one of the most widely used structured interviews developed by David Shaffer, M.D. and his team at Columbia University. The results were stunning.<i> Nine-, 10- and 11-year-old children understood only 38 percent of the questions on the DISC-2</i>. Given its intensely embarrassing nature, I was astounded to see a version of Breton's findings in the New Research section of the 1993 annual meeting of American Academy of Child and Adolescent Psychiatry. When I asked him what his findings said about our field, Breton replied with a very sad smile, "That the child is of secondary importance in child psychiatry." How true, I thought to myself, but unfortunately your findings are likely have zero impact on the education and mental health community.</font></div> <div><font face=3D"Arial" color=3D"#000000"><br></font></div> <div><font face=3D"Arial" color=3D"#000000">Once again I was surprised to see the establishment take note of Breton's troubling data when, in July of 1995, the<i> Journal of the American Academy of Child and Adolescent Psychiatry</i> published a more polished version of the 1993 New Research version. True to form, in her discussion of the article, Mary Schwab-Stone, M.D. of the Yale Child Study Center wrote that "The endeavor to make the DISC good enough has taken longer than anyone wanted, as work began on it around 1980...." What Breton's data called into question in 1991-and remains unchallenged even today--is not the less-than-polished state of the<i> Diagnostic Interview Schedule for Children</i> but, rather, the field's very understanding of children. It is sobering, to say the least, that one of this country's premier academic child psychiatry divisions could be so out-of-touch with a realistic understanding of children that it never even noticed that its instrument was incomprehensible to the very children it was designed to assess.</font></div> <div><font face=3D"Arial" color=3D"#000000"><br></font></div> <div><font face=3D"Arial" color=3D"#000000">That historical anecdote from our ever-increasing "scientific" sophistication is but a minuscule tip of an amazingly large and embarrassing iceberg.</font></div> <div><font face=3D"Arial"><br></font></div> <div><font face=3D"Arial" color=3D"#000000" >http://www.theage.com.au/national/specialist-teams-will-target-youth<span ></span>-20091014-gxfy.html (101609)<br> Specialist teams will target youth<br> NICK MILLER<br> October 15, 2009<br> <br> =46our new youth mental health teams, due to be announced this month, will go into schools, youth centres and perhaps even shopping centres and railways stations to identify and help young people with early signs of mental illness.<br> <br> The teams will be on the look out for drug and alcohol problems, depression, anxiety or eating disorders, as well as the early stages of more serious psychosis.<br> <br> They are the first steps in the State Government's mental health strategy, released in March this year, which has a new focus on intervening early in mental illness.<br> <br> Minister for Mental Health Lisa Neville said the teams would, for the first time, help young people who would be classified ''not sick enough'' in the existing system.<br> <br> Three-quarters of mental illness begins before age 25, but due to a short supply of care only the sickest of young people can get access.<br> <br> Paul Leyden, who runs child and adolescent mental health at Eastern Health and will set up one of the new teams, said it was a very exciting initiative. ''We know 3 per cent of the population have mental health issues but we are seeing less than 1 per cent,'' he said.<br> <br> The teams will start work this year or early 2010 in eastern and western regions, followed by two more at Southern Health and Peninsula Health later next year.</font><br> <font face=3D"Arial" color=3D"#000000"></font></div> <div><font face=3D"Arial" color=3D"#000000">The Government is providing $13.8 million to staff and resource the new teams, as well as $4.4 million for teams at primary schools to deal with early ''conduct disorder'', and $2.9 million to tackle autism.</font><br> </div> <div><font face=3D"Arial"><br></font></div> <blockquote type=3D"cite" cite><font face=3D"Arial">[A] ... research group here in Australia has just demonstrated how a probe inserted in the ear can be used to diagnose certain mental illnesses when the patient is moved incertain ways in a '3D' chair! They make use of the proximity between certain auditory functions and other mental functions in the brain.<br> <br> Regards,<br> David</font><br> </blockquote> <blockquote type=3D"cite" cite><font face=3D"Arial">Dr David Hirst</font></blockquote> <blockquote type=3D"cite" cite><font face=3D"Arial">Curriculum, Teaching and Learning Centre</font></blockquote> <blockquote type=3D"cite" cite><font face=3D"Arial">| La Trobe University | Bundoora 3086 Victoria Australia |</font><br> <font face=3D"Arial"></font></blockquote> <div><font face=3D"Arial" >http://www.theage.com.au/national/diagnosis-to-rock-the-world-of-men<span ></span>tal-health-20091014-gxfx.html</font><br> </div> <div><font face=3D"Arial"><br></font></div> <x-sigsep><pre>-- </pre></x-sigsep> <div>=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D=3D=3D<br> Denis M. Donovan, M.D., M.Ed., F.A.P.S.<br> Director, EOCT Institute<br> <br> Medical Director, 1983 - 2006<br> The Children's Center for Developmental Psychiatry<br> St. Petersburg, Florida<br> <br> Mail:<x-tab> </x-tab>P.O Box 47576<br> <x-tab> </x-tab>St. Petersburg, FL 33743-7576<br> Phone:<x-tab> </x-tab>727-641-8905<br> Email:<x-tab> </x-tab>DenisDonovan@xxxxxxxx<br> =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D= =3D=3D=3D</div> </body> </html> --============_-956402495==_ma============--